Annals of Occupational and Environmental Medicine

Original Article

Association between hearing loss and high-sensitivity C-reactive protein: the Kangbuk Samsung Cohort Study: Jihoon Kim, Yesung Lee, Eunhye Seo, Daehoon Kim, Jaehong Lee, Youshik Jeong, Seonghyun Kwon, Jinsook Jeong, Woncheol Lee; Ann Occup Environ Med 2023;35:e38. Published online September 11, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e38

Abstract Abstract in Korean PDF PubReader ePub: Background
Hearing loss (HL) is linked to an elevated risk of cardiovascular diseases (CVDs). The pathogeneses of HL and CVD commonly involve inflammatory responses. Previous studies investigated elevated levels of inflammatory biomarkers in subjects with HL, however, their findings did not demonstrate statistical significance. In our cross-sectional and longitudinal study, we investigated the correlation between HL and increased high-sensitivity C-reactive protein (hsCRP) levels to determine how HL is associated with CVDs.
Methods
We conducted a cross-sectional study with workers aged over 18 years who underwent health check-ups at our institution between 2012 and 2018 (n = 566,507), followed by conducting a longitudinal study of workers aged > 18 who underwent health checkups at least twice at our institution between 2012 and 2018 (n = 173,794). The definition of HL was as an average threshold of ≥ 20 dB in pure-tone air conduction at 0.5, 1.0, and 2.0 kHz in both ears. The incidence of increased hsCRP levels throughout the follow-up period was defined as a level exceeding 3 mg/L. Logistic regression and generalized estimating equations were performed to estimate the risk of increased hsCRP levels according to the occurrence of HL in groups stratified by age.
Results
In the cross-sectional study, the multivariate-adjusted odds ratio (OR) was 1.17 (95% confidence interval [CI]: 1.02–1.34); the OR was 0.99 (95% CI: 0.80–1.22) in those under 40 and 1.28 (1.08–1.53) in those over 40. In the longitudinal study, the multivariable-adjusted OR was 1.05 (95% CI: 0.92–1.19); the OR was 1.10 (95% CI: 0.90–1.35) in those under 40 and 1.20 (1.01–1.43) in those over 40.
Conclusions
This cross-sectional and longitudinal study identified an association between HL and increased hsCRP levels in workers aged over 40 years.; 청력손실과 고감도 C-반응단백의 연관성
목적
청력손실은 심혈관질환 발생 및 사망률 증가와 관련 있다. 청력손실과 심혈관질환의 병인은 공통으로 염증반응을 포함한다. 몇몇 연구에서 청력손실 환자의 염증성 바이오마커 수치가 증가했음을 연구하였으나 유의하지 않은 결과를 제시하였다. 따라서 본 단면연구 및 종단연구에서는 청력손실이 심혈관질환과 어떠한 관련성이 있는지 알아보기 위해 청력손실과 염증성 바이오마커인 고감도 C-반응단백의 연관성을 연구하였다.
방법
2012년부터 2018년까지 우리 기관에서 건강검진을 받은 18세 이상의 근로자를 대상으로 단면연구를 수행하였다 (n=566,507). 이후 2012년부터 2018년까지 우리 기관에서 건강검진을 2회 이상 받은 18세 이상의 근로자를 대상으로 종단연구를 수행하였다 (n=173,794). 청력손실은 3분법에 의한 순음청력역치가 양측 모두 20 dB 이상인 경우로 정의하였다. 추적관찰 동안 고감도 C-반응단백의 증가는 혈중 농도 3 mg/L 초과인 경우로 정의하였다. 청력손실 발생에 따른 고감도 C-반응단백 증가의 위험을 분석하기 위해 로지스틱 회귀분석과 일반화 추정방정식을 활용하였다. 또한 연령에 따라 계층화하여 추가적인 분석을 하였다.
결과
단면연구에서 최종참가자 204,091명 중 난청 유병률은 0.02% 이었다. 다변량 보정 교차비는 1.17 (95% 신뢰구간 1.02-1.34) 이었다. 40세 이하와 초과인 군에서는 각각 0.99 (0.80-1.22) 와 1.28 (1.08-1.53) 이었다. 종단연구에서 추적관찰 동안 고감도 C-반응단백 수치는 청력손실군 2,349 명 중 272 명, 비청력손실군 116,301명 중 11,049 명에서 증가하였다. 다변수 보정 교차비는 1.05 (95% 신뢰구간 0.92-1.19) 이었다. 40세 이하와 초과인 군에서는 각각 1.10 (0.90-1.35) 과 1.20 (1.01-1.43) 이었다.
결론
본 단면연구 및 종단연구에서는 40세 초과하는 근로자에서 청력손실과 고감도 C-반응단백의 증가에 유의한 연관성이 있음을 확인하였다.

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Original Article

Exposure to polycyclic aromatic hydrocarbons and serum total IgE in the Korean adults: the Third Korean National Environmental Health Survey (2015–2017): Jeong Hun Jo, Dae Hwan Kim, Ji Young Ryu; Ann Occup Environ Med 2022;34:e43. Published online December 14, 2022; DOI: https://doi.org/10.35371/aoem.2022.34.e43

Abstract Abstract in Korean PDF PubReader ePub

Background

Polycyclic aromatic hydrocarbons (PAHs) have become common pollutants with industrial development. Although the effect of exposure to PAHs on allergic disease in humans has been evaluated, evidence of an association is sparse. The association between PAH exposure and serum total immunoglobulin E (IgE) levels was evaluated in Korean adults.

Methods

In total, this study included 3,269 participants in the Third Korean National Environmental Health Survey (2015–2017). Four urinary PAH metabolites were used to assessed exposure to PAHs: 1-hydroxypyrene, 1-hydroxyphenanthrene, 2-naphthol, and 2-hydroxyfluorene. The analyses were performed on 3 cutoff levels (100 IU/mL, 114 IU/mL, and 150 IU/mL) set as the total IgE elevation. Prevalence of total IgE elevation by PAH exposure group and general characteristics (age, sex, BMI, smoking, alcohol drinking, and occupation) were analyzed using the Rao–Scott χ² test. Multiple logistic regression analyses were conducted to calculate adjusted odds ratios (ORs) for total IgE elevation by PAH exposure groups.

Results

Total IgE elevation differed significantly by age, sex, smoking status, alcohol drinking status, and occupation. For 2-hydroxyfluorene, the fourth quartile showed a significant association with IgE elevation compared to the first quartile in the analyses of cutoff-level 100 IU/mL (OR: 1.372, 95% confidence interval [CI]: 1.007–1.869) and 114 IU/mL (OR: 1.643, 95% CI: 1.167–2.312). In the analysis of cutoff-level 150 IU/mL, the adjusted ORs of the third and fourth quartile of 2-hydroxyfluorene were significantly higher than the first quartile (3rd quartile: OR: 1.478, 95% CI: 1.034–2.113; 4th quartile: OR: 1.715, 95% CI: 1.161–2.534). However, there were no significant positive associations for the other metabolites.

Conclusions

This study implied that PAHs exposure is associated with total IgE elevation in Korean adults. More research is needed to confirm the effect of exposure to PAHs on serum IgE and allergic diseases.

다환 방향족 탄화수소 노출과 혈중 총 면역글로불린 E (제3기 국민환경보건 기초조사 2015-2017)
목적
다환 방향족 탄화수소(Polycyclic Aromatic Hydrocarbons, PAHs)는 화석 연료, 폐기물, 목재 등의 여러 유기물의 불완전 연소에 의해서 발생하는 환경 및 직업상 오염물질로서, 산업 발전으로 인해 생활 곳곳에서 노출이 가능한 오염물질이 되었다. PAHs노출과 알레르기 질환과의 관련성을 보여주는 연구 결과들이 있으나 부족한 실정이다. 본 연구에서는 제3기 국민환경보건기초조사(2015-2017) 자료를 이용하여 국내 성인에서 PAHs 노출과 알레르기 지표 중 하나인 혈중 총 면역글로불린 E(IgE)의 관련성을 평가하였다.
방법
국민환경보건 기초조사(2015 - 2017) 제3기에 참여한 성인 3269명을 대상으로 가중치를 적용하여 분석하였다. PAHs에 대한 노출에 대한 지표로 요중 1-hydroxypyrene, 2-naphthol, 1-hydroxyphenanthrene, 2-hydroxyfluorene 농도를 이용하였고, 혈중 total IgE의 증가 여부는 100 IU/mL, 114 IU/mL, 150 IU/mL를 기준으로 설정하여 분석하였다. 요중 PAHs 대사체 농도는 사분위수 기준 네 그룹으로 나누어 분석에 이용하였다.
나이, 성별, BMI, 흡연 여부, 알코올 섭취 여부, 직업군 등 인구학적 요인에 따른 혈중 total IgE 증가 여부 및 각 대사체의 사분위수 그룹에 따른 혈중 total IgE 증가 여부를 카이제곱 검정을 이용하여 분석하였다. 로지스틱 회귀분석을 이용하여 요중 PAHs 대사체 농도 사분위수 그룹과 혈중 total IgE 농도 증가와의 관련성을 파악하고자 하였다.
결과
총 IgE 상승은 연령, 성별, 흡연 여부, 음주 여부, 직업에 따라 유의한 차이를 보였다.
나이, 성별, 흡연 여부, 알코올 섭취 여부, 직업군 등 요인들을 보정한 로지스틱 회귀분석에서는 2-hydroxyfluoren의 경우 IgE 증가를 100IU/mL 및 114IU/mL로 설정한 분석에서 4사분위수 그룹이 1사분위수 그룹과 비교하여 혈중 total IgE 증가에 대해 유의하게 높은 교차비를 보였다(100 IU/mL을 IgE 증가 기준으로 분석 시: OR 1.372, 95% CI 1.007-1.869; 114 IU/mL을 IgE 증가 기준으로 분석 시: OR 1.643, 95% CI 1.167-2.312). 혈중 total IgE의 증가를 150IU/mL로 설정한 분석에서는 2-hydroxyfluoren의 3사분위 그룹과 4분위수 그룹의 total IgE 증가에 대한 교차비가 1사분위수 그룹과 비교하여 유의하게 더 높았다(3사분위수 그룹: OR 1.478, 95% CI 1.034-2.113; 4사분위수그룹: OR 1.715, 95% CI 1.161-2.534). 그러나 다른 대사 산물들에 대한 분석에서는 유의한 연관성이 없었다.
결론
본 연구의 결과는 한국 성인의 PAHs 노출과 총 IgE 수준 사이에 연관성이 있음을 제시한다. PAHs 노출이 혈청 IgE와 알레르기 질환에 미치는 영향을 평가하기 위해서는 추가적인 연구가 더 필요할 것으로 보인다.

Citations

Citations to this article as recorded by

Association of mixed polycyclic aromatic hydrocarbons exposure with oxidative stress in Korean adults
Ji Young Ryu, Dong Hyun Hong
Scientific Reports.2024;[Epub] CrossRef

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Research Article

Association between the prevalence of allergic reactions to skin prick tests and workplace types among agricultural workers in South Korea: Jiyoung Han, Yangwoo Kim, Sooyeon Lee, Soo-Jin Lee; Ann Occup Environ Med 2020;32:e36. Published online November 11, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e36

Abstract PDF PubReader ePub

Background

Farmers are often exposed to dust, molds, pollen, animal products, insects, and chemicals. Accordingly, they have a high prevalence of respiratory and allergic diseases. Some studies have shown that farmers have a high prevalence of respiratory diseases and symptoms depending on where farmers work. The objective of the present study was to investigate whether certain types of agricultural workplaces are associated with the prevalence of allergic reactions in skin prick tests (SPTs) in South Korea.

Method

A total of 149 farmers, grouped according to their workplaces in greenhouses, poultry houses, or outdoors, answered a self-reported questionnaire about the prevalence of respiratory diseases and symptoms. They were skin-tested using 12 allergens. The questionnaire and the prevalence of positive skin tests were determined for each of the participant groups, and the results were analyzed by multivariate logistic regression.

Results

There were significant differences in the prevalence of allergic reactions to the SPT, chronic obstructive pulmonary diseases (COPDs) and asthma symptoms (wheezing) among the subgroups. The allergic reaction to SPT was the highest in greenhouse workers (30.9%), followed by poultry house workers (15.9%), and outdoor workers (8.1%). The prevalence of COPD was 6.8% in poultry house workers alone and not in other groups. The prevalence of wheezing was the highest at 9.1% in poultry house workers. According to the results of the logistic analysis, the prevalence of allergic reactions to SPT had positive correlations with the types of workplaces. Greenhouse workers had higher risk of SPT sensitization compared to outdoor workers (adjusted odds ratio [OR]: 5.55, 95% confidence interval [CI]: 1.32–32.24). The prevalence of SPT positivity also had an association with the symptoms of sneezing, rhinorrhea, or nasal congestion (adjusted OR: 6.64, 95% CI: 2.06–23.63).

Conclusions

These data demonstrate that the types of workplaces were associated with the prevalence of allergic sensitization. This could be explained by the difference in the type or level of airborne exposures in each workplace. It is also likely that this was caused by differences between groups of individual factors such as age and BMI that influence SPT sensitization.

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New Developments in Climate Change, Air Pollution, Pollen Allergy, and Interaction with SARS-CoV-2
Gennaro D’Amato, Isabella Annesi-Maesano, Benedetta Biagioni, Andrea Lancia, Lorenzo Cecchi, Maria Concetta D’Ovidio, Maria D’Amato
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Research Article

The effect of shift work on high sensitivity C-reactive protein level among female workers: Ho Sung Kwak, Hyoung Ouk Park, Young Ouk Kim, Jun Seok Son, Chan Woo Kim, Jun Ho Lee, Young Hoo Shin, Seung Hyun Park, Eui Yup Chung, Chang Ho Chae; Ann Occup Environ Med 2019;31:e5. Published online May 28, 2019; DOI: https://doi.org/10.35371/aoem.2019.31.e5

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Background

This study assessed the association between shift work and high-sensitivity C-reactive protein (hs-CRP) level, a risk factor for cardiovascular disease (CVD), in female workers in electronics manufacturing services (EMS).

Methods

Female EMS workers who received special medical examinations for workers in Gyeongnam, Korea between January 2017 and December 2017 were enrolled in this study. Their age, marital status, education level, alcohol consumption, smoking habit, regular exercise, quality of sleep, work stress, and depression were investigated, and blood tests were conducted. The t- and χ² tests were conducted to compare the general and biochemical characteristics between daytime and shift worker groups. Age-adjusted partial correlation analysis was performed to examine the linear relationship between hs-CRP level and other risk factors for CVDs. In addition, the difference in hs-CRP levels according to work schedule was analyzed by ANCOVA after adjusting for variables that could affect the hs-CRP level.

Results

Although the average hs-CRP levels did not differ significantly between daytime and shift workers (0.92 ± 1.87 and 1.07 ± 2.20 mg/dL, respectively), shift workers tended to show a higher hs-CRP level (p = 0.067). After adjusting for variables that can affect the hs-CRP level, the estimated average hs-CRP level was significantly higher in shift workers (1.325 ± 0.156 mg/dL) than that in daytime workers (0.652 ± 0.350 mg/dL) (p = 0.003).

Conclusions

The results of this study identified a relationship between shift work and hs-CRP level increase in women. Because multiple studies have reported associations between increased hs-CRP and CVD, follow-up of hs-CRP may help early detection of CVD in shift workers.

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Research Article

Night shift work and inflammatory markers in male workers aged 20–39 in a display manufacturing company: Seong-Woo Kim, Eun-Chul Jang, Soon-Chan Kwon, Wook Han, Min-Sung Kang, Young-Hyeon Nam, Yong-Jin Lee; Ann Occup Environ Med 2016;28:48. Published online September 20, 2016; DOI: https://doi.org/10.1186/s40557-016-0135-y

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Background

This study aimed to determine the association between shift work and inflammatory markers, which are independent risk factors of cardiovascular diseases, in male manual workers at a display manufacturing company.

Methods

This study was conducted between June 1 and July 31, 2015 on 244 male manual workers aged 20–39 years old at a display manufacturing company and investigated age, marital status, education level, alcohol consumption habit, smoking habit, regular exercise habit, sleep duration, sleep debt, sleep insufficiency, past medical history, current and past shift work experience, duration of shift work, and weekly work hours through face-to-face interviews using structured questionnaires and performed blood tests. Study participants were divided into daytime, former shift, and current shift workers based on the work schedule. Chi-square tests and one-way analyses of variance were performed to compare inflammatory markers and cardiovascular disease risk factors, and analyses of covariance were conducted after adjusting for variables potentially affecting inflammatory markers.

Results

High-sensitivity C-reactive protein (hs-CRP; mean ± standard deviation) levels in daytime, former shift, and current shift workers were 0.65 ± 0.43, 0.75 ± 0.43, and 0.86 ± 0.72 mg/L, respectively (p = 0.029). The leukocyte count (mean ± standard deviation) was 5,556 ± 1,123, 6,210 ± 1,366, and 6,530 ± 1,216 cells/μL, respectively (p < 0.001). Both hs-CRP level and leukocyte count were significantly higher in current shift workers than in daytime workers, and leukocyte count was higher in former shift workers than in daytime workers. After adjusting for variables potentially affecting inflammatory markers, hs-CRP levels (adjusted mean ± standard deviation) in daytime and current shift workers were 0.59 ± 0.06 and 0.92 ± 0.07 mg/L, respectively (p = 0.002). The leukocyte count (adjusted mean ± standard deviation) was 5,557 ± 124 and 6,498 ± 144 cells/μL, respectively (p < 0.001).

Conclusions

A significant association between shift work and increases in inflammatory markers was confirmed. Because chronic low-grade inflammation plays an important role in the development of cardiovascular diseases, regular follow-up of inflammatory markers as a marker of cardiovascular diseases in shift workers may serve as an early indicator in predicting the effects of shift work on health.

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Case Report

Multiple chemical sensitivity caused by exposure to ignition coal fumes: a case report: Myeong-Ja Yun, Dong-Mug Kang, Kyoung-Hye Lee, Young-Ki Kim, Jong-Eun Kim; Ann Occup Environ Med 2013;25:32-32. Published online November 1, 2013; DOI: https://doi.org/10.1186/2052-4374-25-32

Abstract PDF PubReader ePub

Background

Although multiple chemical sensitivity (MCS) is a well-known disorder caused by environmental exposures, MCS caused by occupational exposure has been reported in Korea. Therefore, we report a MCS case caused by environmental exposure to ignition coal after a differential diagnosis to exclude other diseases.

Case report

Since 2011, a 55-year-old woman had experienced edema, myalgia, and other symptoms when she smelled ignition coal near her workplace. She had been diagnosed with fibromyalgia syndrome(FMS) and was treated, with no improvement of symptoms. Since then, she showed the same symptoms after exposure to city gas, the smell of burning, and exhaust gas. To avoid triggering substances, she moved to a new house and used an air purifier. She quit her job in November 2012. After visiting our hospital, she underwent a differential diagnosis for FMS, chronic fatigue syndrome, and somatization disorder. She was diagnosed with MCS by the Korean version of the Quick Environment Exposure Sensitivity Inventory (QEESI). She was educated about the disease and to avoid triggering substances. She received ongoing treatment for her symptoms.

Conclusion

This case showed that symptoms began after smelling ignition coal. After that, her triggers was increased such as the smell of city gas, burning, and exhaust gas. This case is the first reported in Korea of MCS due to environmental exposure after ruling out other diseases.

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Adverse effect propensity: A new feature of Gulf War illness predicted by environmental exposures
Beatrice A. Golomb, Jun Hee Han
iScience.2023; 26(8): 107363. CrossRef
Toxicant-induced loss of tolerance for chemicals, foods, and drugs: assessing patterns of exposure behind a global phenomenon
Shahir Masri, Claudia S. Miller, Raymond F. Palmer, Nicholas Ashford
Environmental Sciences Europe.2021;[Epub] CrossRef
Mast cell activation may explain many cases of chemical intolerance
Claudia S. Miller, Raymond F. Palmer, Tania T. Dempsey, Nicholas A. Ashford, Lawrence B. Afrin
Environmental Sciences Europe.2021;[Epub] CrossRef
An Unusual Case of Multiple Food Allergies Comorbid with Multiple Chemical Sensitivity: A Case Report
Veronica Storino, Juliana Muñoz-Ortiz, Valeria Villabona-Martinez, Juan Diego Villamizar-Sanjuán, William Rojas-Carabali, Alejandra de-la-Torre
Journal of Asthma and Allergy.2021; Volume 14: 317. CrossRef
Three questions for identifying chemically intolerant individuals in clinical and epidemiological populations: The Brief Environmental Exposure and Sensitivity Inventory (BREESI)
Raymond F. Palmer, Carlos R. Jaén, Roger B. Perales, Rodolfo Rincon, Jacqueline N. Forster, Claudia S. Miller, Wen-Jun Tu
PLOS ONE.2020; 15(9): e0238296. CrossRef
Multiple Chemical Sensitivity Syndrome: A Principal Component Analysis of Symptoms
Antonio Del Casale, Stefano Ferracuti, Alessio Mosca, Leda Marina Pomes, Federica Fiaschè, Luca Bonanni, Marina Borro, Giovanna Gentile, Paolo Martelletti, Maurizio Simmaco
International Journal of Environmental Research and Public Health.2020; 17(18): 6551. CrossRef

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Case Report

A Case of Hypersensitivity Pneumonitis with Giant Cells in a Female Dental Technician: Yong-Hyun Kim, Yun Kyung Chung, Changhwan Kim, Eun suk Nam, Hyun-Jun Kim, Youngsu Joo; Ann Occup Environ Med 2013;25:19-19. Published online October 4, 2013; DOI: https://doi.org/10.1186/2052-4374-25-19

Abstract PDF PubReader ePub

Objectives

Dental technicians are exposed to methyl methacrylate(MMA) and hard metal dusts while working, and several cases of hypersensitivity pneumonitis caused by the exposure have been reported. The authors experienced a case of hypersensitivity pneumonitis in a female dental technician who had 10 years’ work experience and report the case with clinical evidence.

Method

The patient’s work, personal, social, and past and present medical histories were investigated based on patient questioning and medical records. Furthermore, the workplace conditions and tools and materials the patient worked with were also evaluated. Next, the pathophysiology and risk factors of pneumonitis were studied, and studies on the relationship between hypersensitivity pneumonitis and a dental technician’s exposure to dust were reviewed. Any changes in the clinical course of her disease were noted for evaluation of the work-relatedness of the disease.

Results

The patient complained of cough and sputum for 1 year. In addition, while walking up the stairs, the patient was not able to ascend without resting due to dyspnea. She visited our emergency department due to epistaxis, and secondary hypertension was incidentally suspected. Laboratory tests including serologic, electrolyte, and endocrinologic tests and a simple chest radiograph showed no specific findings, but chest computed tomography revealed a centrilobular ground-glass pattern in both lung fields. A transbronchial biopsy was performed, and bronchoalveolar washing fluid was obtained. Among the findings of the laboratory tests, microcalcification, noncaseating granuloma containing foreign body-type giant cells, and metal particles within macrophages were identified histologically. Based on these results, hypersensitivity pneumonitis was diagnosed. The patient stopped working due to admission, and she completely quit her job within 2 months of restarting work due to reappearance of the symptoms.

Conclusion

In this study, the patient did not have typical radiologic findings, but pathological evaluation of the lung biopsy from the bronchoscope led to the suspicion of pneumonitis. Under the microscope, the sample contained fibrotic changes in the lung, multinucleated giant cells, and particles in macrophages and was diagnosed as dental technician pneumoconiosis by the pathology. Working as a dental technician had directly exposed her to light metal dust and MMA, and her clinical symptoms and radiologic findings subsided after withdrawal from exposure to the workplace. These outcomes led to the diagnosis of hypersensitity pneumonitis due to MMA exposure and strong work-relatedness.

Citations

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Interstitial pulmonary disease and aluminum trihydrate exposure: A single case report and detailed workplace analysis
Claudia Corwin, Hillary Waterhouse, Jerrold L. Abraham, Soma Sanyal, Judith A. Crawford, Matthew Caddell, Michael J. Hodgson
American Journal of Industrial Medicine.2024; 67(3): 274. CrossRef
The effect of Eucalyptol on SOD and IL-10 expression in mice exposed to Methyl methacrylate vapor
Sianiwati Goenharto, Elly Rusdiana, Sherman Salim, I Ketut Sudiana
Research Journal of Pharmacy and Technology.2021; : 2999. CrossRef
Assessment and Management of Occupational Hypersensitivity Pneumonitis
Iñigo Ojanguren, Vincent Ferraro, Julie Morisset, Xavier Muñoz, Jordan Fink, María Jesús Cruz
The Journal of Allergy and Clinical Immunology: In Practice.2020; 8(10): 3295. CrossRef
Hard Metal Lung Disease: Update in Diagnosis and Management
Matthew Zheng, Robert M. Marron, Sameep Sehgal
Current Pulmonology Reports.2020; 9(2): 37. CrossRef
Hard Metal Lung Disease with Favorable Response to Corticosteroid Treatment: A Case Report and Literature Review
Yosuke Chiba, Takashi Kido, Masahiro Tahara, Keishi Oda, Shingo Noguchi, Toshinori Kawanami, Mitsuru Yokoyama, Kazuhiro Yatera
The Tohoku Journal of Experimental Medicine.2019; 247(1): 51. CrossRef
Small Airways Disease Related to Occupational Exposures
Mridu Gulati, Ann Teng
Clinical Pulmonary Medicine.2015; 22(3): 133. CrossRef

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Review

Multiple Chemical Sensitivity: Hong Jae Chae, Byoung Gwon Kim, Hwan Cheol Kim, Mi Young Lee, Jong Han Leem; Korean Journal of Occupational and Environmental Medicine 2012;24(4):328-338. Published online December 31, 2012; DOI: https://doi.org/10.35371/kjoem.2012.24.4.328

Abstract PDF

This article reviews newly available knowledge on multiple chemical sensitivity (MCS), a chronic medical condition characterized by symptoms in multiple organ and caused by exposure to low levels of common chemicals. Although various pathophysiological models have been proposed (including toxicological, immunological or behavioral models), the causes and underlying mechanisms of MCS are still not fully understood. Most patients with MCS were women between the ages of 30 and 50 years. The most frequently reported trigger was a newly constructed home or job site. The common symptoms are vague, non-specific complaints: fatigue, difficulty concentrating, poor memory, sneezing/runny nose, headache, and muscle pain. There are no laboratory markers or specific investigative findings for MCS. The Quick Environmental Exposure and Sensitivity Inventory (QEESI)(c) has been used as a screening questionnaire. Treatment focuses on assisting patients at the earliest possible opportunity to reduce their exposure to unique symptom triggers and known hazardous chemicals. Early comprehensive assessment, medical management, and social and financial support might avoid the deterioration of functions associated with prolonged illness.

Citations

Citations to this article as recorded by

MCS/IEI Prevalence Rate of Workers Around an Accidental Release of Hydrogen Fluoride in Gumi Industrial Complex
Hye-Ji Han, Kuck-Hyeun Woo, Sung-Yong Choi, Byoung-Hak Jeon, Sangjun Choi
Journal of Korean Society of Occupational and Environmental Hygiene.2015; 25(4): 534. CrossRef

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Original Article

A Validation of the Korean Version of QEESI(c) (The Quick Environmental Exposure and Sensitivity Inventory): Byoung Hak Jeon, Se Hoon Lee, Hyoung Ah Kim; Korean Journal of Occupational and Environmental Medicine 2012;24(1):96-114. Published online March 31, 2012; DOI: https://doi.org/10.35371/kjoem.2012.24.1.96

Abstract PDF

OBJECTIVES
A standardized questionnaire is not available for use as a screening tool to assess individuals with MCS/IEI in Korea. The QEESI(c), originally developed by Miller & Prihoda in 1998, helps researchers, doctors, and their patients identify individuals with MCS/IEI. Therefore, this study was conducted in order to create a Korean version of the QEESI(c) and evaluate whether this Korean version could be used as an effective MCS/IEI screening tool in Korea.
METHODS
The Korean version of the QEESI(c) was developed using a six-step approach: permission, forward translation, the first quality control, backward translation, cognitive debriefing and the second quality control, final proof reading. In order to collect data, we have done a sample survey in certain parts of Korea. A household was used as the sampling unit; we extracted random samples in each survey cluster and then interviewed two adults over 19 years of age living in each sampled household. A total of 300 subjects were recruited from the general population in local community. The factor structure in the Korean version of the QEESI was analyzed with 40 items on four sub-scales except for the 10 items in masking index using principal components analysis with Varimax rotation. A convergent validity test two sub-scales: chemical intolerance and symptom severity. We carefully compared the chemical intolerance with Nordin's chemical sensitivity scale and the symptom severity with Cho's subjective symptom score.
RESULTS
The results showed that the 40 items on the four sub-scales,' chemical intolerances',' symptom severity', 'life impact', and 'other intolerances', were consistent with those reported for the US population by Miller and Prihoda. The convergent validity wes very good (r=0.4; p<0.001, r=0.5; p<0.001, respectively). A good internal consistency (Cronbach' alpha=0.86~0.96) and test-retest reliability (r=0.87~0.90) were found in all scales, except for the internal consistency in the masking index.
CONCLUSIONS
The Korean version QEESI(c) showed a good reliability and validity. It should be necessary to conduct a MCS/IEI study adopting Korean version QEESI(c).

Citations

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What initiates chemical intolerance? Findings from a large population-based survey of U.S. adults
Claudia S. Miller, Raymond F. Palmer, David Kattari, Shahir Masri, Nicholas A. Ashford, Rodolfo Rincon, Roger B. Perales, Carl Grimes, Dana R. Sundblad
Environmental Sciences Europe.2023;[Epub] CrossRef
Does improving indoor air quality lessen symptoms associated with chemical intolerance?
Roger B. Perales, Raymond F. Palmer, Rudy Rincon, Jacqueline N. Viramontes, Tatjana Walker, Carlos R. Jaén, Claudia S. Miller
Primary Health Care Research & Development.2022;[Epub] CrossRef
Disease comorbidities associated with chemical intolerance
RaymondF Palmer, Tatjana Walker, RogerB Perales, Rodolfo Rincon, CarlosRoberto Jaén, ClaudiaS Miller
Environmental Disease.2021; 6(4): 134. CrossRef
Three questions for identifying chemically intolerant individuals in clinical and epidemiological populations: The Brief Environmental Exposure and Sensitivity Inventory (BREESI)
Raymond F. Palmer, Carlos R. Jaén, Roger B. Perales, Rodolfo Rincon, Jacqueline N. Forster, Claudia S. Miller, Wen-Jun Tu
PLOS ONE.2020; 15(9): e0238296. CrossRef
MCS/IEI Prevalence Rate of Workers Around an Accidental Release of Hydrogen Fluoride in Gumi Industrial Complex
Hye-Ji Han, Kuck-Hyeun Woo, Sung-Yong Choi, Byoung-Hak Jeon, Sangjun Choi
Journal of Korean Society of Occupational and Environmental Hygiene.2015; 25(4): 534. CrossRef
Allergic Diseases and Multiple Chemical Sensitivity in Korean Adults
Inchul Jeong, Inah Kim, Hye Jung Park, Jaehoon Roh, Jung-Won Park, Jae-Hyun Lee
Allergy, Asthma & Immunology Research.2014; 6(5): 409. CrossRef

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Original Article

The Relationship between Job Stress and hsCRP: Jong Heon Lee, Tae Won Chang, Young Jun Kwon, Yong Kyu Kim, Sang Chul Ryu, In Suk Kim; Korean Journal of Occupational and Environmental Medicine 2011;23(3):261-269. Published online September 30, 2011; DOI: https://doi.org/10.35371/kjoem.2011.23.3.261

Abstract PDF

OBJECTIVES
We wanted to investigate the relationship between job stress and high-sensitivity C-reactive proteins (hsCRP) with a view to using them as a predictor of future cardiovascular events.
METHODS
The study subjects were 155 male bank workers. A structured, self-assesment questionnaire was used to analyze the sociodemographic characteristics and job stress of the participants. Seven levels of job stress, as described in the Korean Occupational Stress Scale-Short Form (KOSS-SF), were used to categorized the participants. We included tests for blood pressure, fasting blood sugar, blood lipid level (total cholesterol, HDL-cholesterol, LDL-cholesterol and triglycerides), and hsCRP in our analysis. Multiple logistic regression modeling was used to determine an association between job stress and cardiovascular risk factors including hsCRP.
RESULTS
In the multiple logistic regression analyses adjusted for general and job characteristics and cardiovascular risk factors, interpersonal conflict (adjusted OR 1.69, 95% CI=1.11~2.57), job insecurity (adjusted OR 1.94, 95% CI=1.24~3.03) and, occupational climate (adjusted OR 1.89, 95% CI=1.19~3.01) were associated with hsCRP.
CONCLUSION
This study suggests that job stress is associated with hsCRP which is a predictor of future cardiovascular events.

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Sung-Joon Woo, Chang-Ho Chae, Jae-Won Lim
Annals of Occupational and Environmental Medicine.2022;[Epub] CrossRef
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Keiki Ogino, Tatsuo Ito, Eri Eguchi, Kenjiro Nagaoka, Markus M. Bachschmid
PLOS ONE.2017; 12(4): e0175696. CrossRef

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Case Report

Hot Tub Lung Due to Mycobacterium Avium Complex in a Public Bath: Chung Won Kang, Yun Kyung Chung, Hye Eun Lee, Eun A Kim, Yun Chul Hong, Soo Hun Cho; Korean Journal of Occupational and Environmental Medicine 2010;22(2):166-172. Published online June 30, 2010; DOI: https://doi.org/10.35371/kjoem.2010.22.2.166

Abstract PDF: BACKGROUND
Hot tub lung is a hypersensitivity pneumonitis caused by nontuberculous mycobacteria (NTM); the primary causative agent is Mycobacterium avium complex (MAC) post contaminated water exposure. Recently, 2 cases of hot tub lung were found in public bath bodyscrubbers working in Korea. However, the disease causing NTM was not identified in these cases. Here, we reported one case, along with clinical diagnostic approach to occupational medicine throughout worksite investigation.
CASE
A 53 year-old woman working in the public bath for 13 months' duration developed shortness of breath. She had been cleaning the locker room, several pools and floors every day, and using scrubbers with detergent and warm water. After examination, the patient was diagnosed with hypersensitivity pneumonitis based on high resolution computerized tomography and lung biopsy. Because the Mycobacterium avium was identified in both the patient's sputum and the warm pool, she was diagnosed with hot tub lung due to MAC.
CONCLUSION
Hot tub lung due to MAC was confirmed in public bath housekeeper. However, few cases have been reported, even though there are many cases. To prevent damages caused by hot tub lung, general environmental management such as ventilation and cleaning is important for bath operators. Likewise, awareness needs to be increased in workers with potential NTM environmental exposure and in clinicians through education about hot tub lung in order to reduce adverse harm from misdiagnosis and mistreatment of tuberculosis.

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Case Report

A Case of Hypersensitivity Pneumonitis in a Worker Exposed to Metal Working Fluid: Sun Wung Lee, Dong hee Ko, Ku Won Chin, Dong Uk Park, Jung Tak Lee, Yoon Hee Song, Sang Yoon Lee; Korean Journal of Occupational and Environmental Medicine 2008;20(1):37-45. Published online March 31, 2008; DOI: https://doi.org/10.35371/kjoem.2008.20.1.37

Abstract PDF

INTRODUCTION: There have been no reports of hypersensitivity pneumonitis caused by metal working fluids in Korea, despite their existence in other countries. Here, we report the first such case, along with an assessment of work-relatedness through exposure assessment.
CASE
REPORT: A 64-year old male patient visited the hospital with dyspnea after metal pipe cutting for about a year. He was diagnosed with hypersensitivity pneumonitis from the evidence of specific exposure history, clinical symptoms, and radiologic findings. The air exposure levels of the oil mist, endotoxin, total bacteria and fungus in the work environment was TWA(8-hr) 0.531 mg/m3, 6.33 EU/m3, 100 CFU/m3 and 75 CFU/m3, respectively. The concentrations of the endotoxin, total bacteria and fungus within the metal working fluid was 1.5x10(4) EU/mL, 4.6x10(5) CFU/mL and 1.8x10(5) CFU/mL, respectively.
DISCUSSION
Although the patient did not receive a specific precipitating antibody test, the microbial concentration within the metal working fluid was higher than normal and similar to previous case reports, The oil mist level in the air exceeded the NIOSH REL and ACGIH NIC, and were similar or higher than previous cases. By excluding other causes of hypersensitivity pneumonitis, we concluded that the disease developed from exposure to microbial antigens in the metal working fluid.

Citations

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Green manufacturing—performance of a biodegradable cutting fluid
Rahul Katna, Kanwarjeet Singh, Narayan Agrawal, Swati Jain
Materials and Manufacturing Processes.2017; 32(13): 1522. CrossRef
Association of Exposure to Chemicals with Dyspnea among Employed Workers: Analysis of the 3rdKorean Working Conditions Survey
Moon-Young Park, Sung-Ho Hwang, Kimyong Hong, Se-Eun Oh, Kyoung-Mu Lee
Journal of Korean Society of Occupational and Environmental Hygiene.2016; 26(1): 64. CrossRef
Microbial Assessment in Metal-Working Fluids Handling Industry
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Microbial Exposure Assessment in Sawmill, Livestock Feed Industry, and Metal Working Fluids Handling Industry
Hyunhee Park, Haedong Park, Inseop Lee
Safety and Health at Work.2010; 1(2): 183. CrossRef

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Original Article

Investigation of Occupational Dermatological Problem with Additives in Polypropylene Manufacturing Process: Seung Ho Jeon, Kyong Min Lee, Kan Woo Yoon, Do Myung Paek, Jong Yeop Yoo, Hee Chul Eun; Korean Journal of Occupational and Environmental Medicine 2003;15(3):252-260. Published online September 30, 2003; DOI: https://doi.org/10.35371/kjoem.2003.15.3.252

Abstract PDF: OBJECTIVES
To investigate the causative agents for the dermatological problems associated with the polypropylene manufacturing process.
METHODS
The study subjects consisted of 44 male workers involved in the polypropylene manufacturing process. Twenty-seven of them had been exposed to additives, and the remaining 17 had not. Among the 27 exposed, 10 had been exposed previously, and 17 are currently being exposed through their duties. Patch test were performed with three different concentrations, 0.1%, 1% and 10% of 10 different additives that was diluted with Vaseline.
RESULTS
18 subjects (41%) had positive reactions to the patch tests. Exposed group had a higher reaction rate (51.9%) than the control group (23.5%). When the positive reactions were further classified, 7, 6 and 5 were compatible with probably irritant, probably allergic, and multiple hypersensitivity reactions respectively. The most frequent reactions were from Ultranox-626 followed by Millad 3988, Armoslip-E and Songstab Sc-100.
CONCLUSIONS
When considering the significantly higher probability of an allergic reaction rate among the currently exposed group compared to non- or previously-exposed groups, the nature of dermatological problems in a polypropylene plant is probably allergic. Ultranox-626, Millad3988, Armoslip-E and Songstab Sc-100 were the main causatives agents found in the process.

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Original Article

Effects of transient threshold shift and ambient noise on sensitivity and specificity of first screening of special health examination for noise: Jong Uk Won, Moon Kyoo Bang, Joong Ho Song, Sedn Ah Jeong, Jae Suk Song, Jaehoon Roh; Korean Journal of Occupational and Environmental Medicine 2000;12(2):269-276. Published online June 30, 2000; DOI: https://doi.org/10.35371/kjoem.2000.12.2.269

Abstract PDF: OBJECT: This study was performed to increase the sensitivity and specificity for screening the examinee of second hearing test.
METHODS
Study subjects were 219 workers who exposed more than average 80dB. They were taken the hearing test two times, before noise exposure and at 1 hour to 4 hours after worksite noise exposure. To investigate the ambient noise workers who were taken the hearing test in the test room which ambient noise was less than 45dB were classified Group I and the others were classified Group E. To calculate the sensitivity and specificity we made it gold standard whether worker had noise induced hearing loss.
RESULTS
Difference of hearing loss between before and after noise exposure for left and right ear was 11. 4 dB and 11. 7 dB respectively at 500 Hz, 8. 7 dB and 9. 6 dB at 1, 000 Hz, 6. 3 dB and 6. 9 dB at 2, 000 Hz and 6. 9 dB and 7. 4 dB at 4, 000 Hz in Group I. That for left ear and right ear was 5.8 dB and 4.9 dB at 500 Hz respectively, 5.4 dB and 6.4 dB at 1,000 Hz, 6.3 dB and 5.3 dB at 2,000 Hz, and 5.5 dB and 5.8 dB at 4,000 Hz in Group E. The sensitivity was 100 in both Groups and the specificity was increased to 58. 3 and 71. 8 in Group I and Group 3 respectively until 10 dB was deducted from hearing level at 1, 000 Hz and 4, 000 Hz.
CONCLUSION
When the screening hearing test was performed at worksite, we might deduct 10 dB from measured hearing level to increase the specificity without reduction of sensitivity.

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